Overview

Music therapy is a form of expressive arts therapy that incorporates a variety of activities, including singing, playing an instrument, and listening to music, to enhance and preserve an individual's physical, psychological, and social well-being.

A qualified practitioner who has completed an authorised program in music therapy uses clinical and evidence-based music treatments to help clients achieve specific goals in a therapeutic setting. This practice is known as music therapy. Numerous medical and educational objectives can be addressed by music therapy interventions, such as:

• Encourage wellbeing
• Control stress
• Reduce pain
• Communicate emotions
• Boost memory
• Boost interaction
• Encourage your physical recovery

Since ancient times, people have utilised music as a therapeutic aid. Research has indicated that music has an impact on several brain regions, such as those related to emotion, thought, movement, and senses. This characteristic, together with the fact that music is entertaining and comes in a variety of formats, makes music particularly useful in treating a wide range of mental and physical issues, such as anxiety, depression, and hypertension.

Travelling music ensembles performed for wounded veterans during and after both World Wars, and as a result, medical professionals and doctors became aware of the therapeutic value of music and asked that professional musicians be employed by the hospitals. As a result, specific training in the right application of music as a therapeutic modality became necessary.

Understanding music therapy

Researchers and medical dissertations from the early 19th century suggested using music therapy for both adults and children. Further proof of the advantages of incorporating music into healthcare came from a physician's study published in 1914, which demonstrated the beneficial effects of employing music during surgery. Thus, the cultural and historical relevance of music therapy confirms the long-held belief that incorporating music and art into medical care is good for patients' mental health.

The use of sound and rhythm for therapeutic purposes has grown in importance as a component of hospital patient care to improve quality of life and aid in recovery. Certified therapists carefully craft music treatments utilising targeted music therapy strategies to meet the needs of each patient in the following ways:

• Melodies that promote healing can help with emotional expression, pain management, and relaxation
• Songs written by the patient, improvisation, or listening exercises customised to their needs are examples of music treatments
• The benefits of music therapy for wellbeing extend beyond enhanced physical health to include mental and emotional wellbeing
• The incorporation of these therapeutic approaches emphasises the value of non-pharmacological intervention strategies in clinical settings and makes a substantial contribution to holistic healthcare

The connection between music and mental health

Music can not only trigger intense emotions but also help regulate them. The frontal regions of the brain, which are involved in processing cognitive and motor functions, include cortical networks linked to emotion that are activated by music.¹

The mesolimbic area and the nucleus accumbens, the brain's reward centre and site of real-life emotional experiences, are two brain regions that have been shown to be activated by music. Psychophysiological factors like blood pressure, heart rate, breathing, pain perception, and relaxation are all affected by music.²

Many cognitive processes, such as information processing, attention, language, memory, and executive skills, are activated during musical performance. An individual's social, cognitive, emotional, and physical wellbeing are all recognised to improve when they listen to music.¹

Four hormones can be used to analyse how music affects neurochemistry:³

• Dopamine and opioids mediate reward, motivation, and pleasure
• Cortisol, corticotropin-releasing hormone (CRH) and adrenocorticotropic hormone (ACTH) mediate stress and arousal
• Serotonin and the peptide derivatives of proopiomelanocortin (POMC), alpha-melanocyte-stimulating hormone, and beta-endorphin mediated immunity
• Oxytocin mediates social affiliation

Applications of music therapy in mental health

Active and receptive strategies can be used to categorise the intervention methods used in music therapy. Active approaches are used when someone is creating music, whether they are composing, improvising, playing an instrument, or singing.

Conversely, receptive tactics entail listening to music and reacting to it in different ways, including dancing or parsing the words. During treatment, active and receptive strategies are frequently mixed and used as launching pads for talking about feelings, values, and objectives.

Both the therapist and the patient can select the music for music therapy, which can be done individually or in groups. When it comes to fulfilling the requirements and objectives of the individual receiving therapy, a music therapist will often make sure the kind and style of music selected, along with the time of the music intervention, are acceptable.

Therapists frequently base their music choices when introducing clients on the Iso principle, which holds that music is more likely to be effective if it resonates with a patient's current state of affairs⁴. Therefore, while choosing a song for a client, therapists attempt to match the lyrics and melody to the client's psychological state and mood.

There are several specific uses for music therapy:

• Speech output and fluency are frequently improved when a person who has had a stroke sings words or brief phrases set to a straightforward melody
• Performing easy piano tunes or tapping out a beat on drum pads might help someone with fine motor impairments become more dexterous. An individual can also benefit from listening to a metronome or other rhythmic stimuli as they are starting, coordinating, and timing their motions

Case studies

A professional musician with a lengthy history of refractory epilepsy did not exhibit any cognitive or musical skill losses prior to or during temporal lobectomy, according to a recent case study. The authors propose that cognitive reserve—acquired through extensive musical training—is responsible for this kind of preservation of cognitive and musical abilities.³

A study involving Parkinson's disease patients revealed a strong relationship between cognitive abilities and the ability to perform different temporal elements of rhythm, including tempo, beat discrimination and beat perception in a musical context.⁴

Goals and objectives of music therapy for mental health

• Music therapy enhances healing by lowering anxiety and the negative physical impacts of stress
• It can support Alzheimer's and Parkinson's disease management
• Seniors with depression respond well to music therapy
• It lessens the signs and symptoms of mental illnesses like schizophrenia
• Communication and self-expression are enhanced by music therapy

Common objectives in music therapy include the development of:⁵

• Communication abilities through verbal and nonverbal noises and gesturing
• Social skills such as proper eye contact, taking turns, striking up conversations, and self-worth
• Sensory abilities by means of touch, hearing, and consciousness levels
• Physical abilities by movement and fine gross motor control
• Cognitive abilities through sequencing, imitation, focus and attention
• Emotional intelligence through nonverbal expression of feelings

Challenges and considerations 

Music therapy has the potential to develop and cause a number of issues. Among these issues are:

Overstimulation

The sound of music is influenced by the acoustics, volume, kind of instruments used, and many more. Music and sound have a strong stimulating connection, which refers to a person's physiological state, such as their heartbeat, movement, blood flow, breathing rate, etc.

When someone is overstimulated by music, it could be because the bass pounding in their chest is too strong or the volume is too high. Babies in neonatal intensive care units(NICU) are particularly vulnerable to this kind of overstimulation. This may result in irritation, discomfort, and neurological stress.

Memory triggering

When it comes to evoking unpleasant memories, music is second only to scent. This can be linked to an evolutionary adaptation to swiftly digest sound as a means of survival. While memory triggering might occasionally give dementia patients moments of clarity, it can also be harmful to PTSD sufferers who do not want to revisit specific experiences.

Anxiety

While music has the potential to reduce anxiety, it can also exacerbate anxiety in others. Alzheimer's patients may become distressed and anxious when listening to inappropriate music. A patient's mental condition can be significantly impacted by the lyrics. Some songs' lyrics may convey an unfavourable attitude and eventually increase feelings of depression, which is particularly intimidating for individuals who suffer from depression.⁶

Summary

In conclusion, music therapy stands as a powerful and versatile tool in promoting mental health and well-being. Its ability to engage individuals on emotional, cognitive, and physiological levels offers a unique approach to address a wide range of mental health challenges. Through personalised interventions tailored to meet individual needs, music therapy facilitates expression, fosters connections, and cultivates coping mechanisms.

As research continues to unveil its effectiveness, integrating music therapy into mainstream mental health care holds significant promise for enhancing treatment outcomes and improving overall quality of life for countless individuals worldwide. Embracing the healing power of music underscores its profound impact as not just an art form, but a therapeutic modality capable of transforming lives.